7 Signs Your Gut Is Out of Whack

by MAGGIE MOON, MS, RDN Last Updated: Aug 31, 2017

Maggie Moon, MS, RDN

Maggie Moon, MS, RDN, is a registered dietitian nutritionist based in Los Angeles, and author of "The MIND Diet" (Ulysses Press, 2016). She holds a Master of Science degree in Nutrition and Education from Columbia University. Connect with her at maggiemoon.com.

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It’s time for a gut check -- literally. “It’s not as easy as one would think to figure out if your gut is healthy or not,” says Kristi King, M.P.H., RDN, spokesperson for the Academy of Nutrition and Dietetics. That’s because, according to Scott Schreiber, D.C., CNS, chiropractic physician and clinical nutritionist, “Signs and symptoms of an unhealthy gut include much more than bloating, constipation or diarrhea.” The gut is a complex organ. And thanks to advances in how we analyze our gut microbiome, researchers are starting to understand the extent of its complexity and finding links between gut health and the health of its gracious host (us). Is your gut as healthy as it could be? Read on for some surprising signs it's imbalanced -- and what to do about it.

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1 DO YOU GET SICK EASILY?

The digestive system is equipped with the largest and most complex part of the human immune system. Among other things, a balanced gut includes microbes that secrete chemical messengers that let immune cells (T cells) know what to do to protect us from pathogens (bad bugs) and foreign substances. Having plenty of good bacteria also protects us by leaving less real estate for opportunistic pathogens that would overgrow if given the space. King says, “The immune system is largely based in the gut, so if you find yourself getting sick frequently, you may need a few more good bacteria in the gut to help out!”

2 DO YOUR JOINTS HURT?

The cause of rheumatoid arthritis (RA), an autoimmune condition that attacks the joints, is unknown. Researchers think the answer may lie in the gut microbiome, perhaps because the gut is such an important part of the immune system. The idea that the gut microbiome could impact immune responses outside the digestive system is new, but it’s been demonstrated in animal studies, as reported in Nature Reviews Rheumatology. Recent findings show that people with RA have unbalanced microbiomes, and the hypothesis is that the wrong bacterial populations overgrow, leading to inflammation. Furthering the gut-joint connection, King adds that rheumatoid arthritis is often associated with other autoimmune conditions, such as celiac disease or inflammatory bowel disease.

3 DO YOU GAIN WEIGHT EASILY?

We don’t know for sure if gut microbiota are to blame for that whole “moment on the lips, a lifetime on the hips” phenomenon, but there are certainly differences seen in the microbiomes in obese versus healthy individuals, and researchers believe there is a link, even if they can’t fully define it yet. Humans are much more complex than mice, but consider that when germ-free mice were given microbiota from an obese person, they became obese, even though they ate less, perhaps because they were able to absorb more calories and store them. Interestingly, a study published in Nature found that the balance of gut microbiota in obese people began to look more like the microbiota of lean people after they improved their diet and exercise. The gut-brain axis may also be involved in sending signals to the brain about satiety and appetite regulation.

4 DO YOU HAVE DIARRHEA AFTER TAKING ANTIBIOTICS?

Antibiotics tend to be blunt instruments, killing off pathogens and beneficial bacteria alike, upsetting the natural balance of good bacteria to bad. Keep in mind that even under normal circumstances, the body houses potentially harmful bacteria, but we just don’t normally notice when the good bacteria outnumber the bad. Without enough good bacteria, bad bacteria can grow out of control, creating toxins that hurt the gut, trigger inflammation and cause diarrhea. King shares that when taking antibiotics, “many times people find it helpful to either take a probiotic or eat probiotic foods like yogurt to help replenish the good bacteria.” Hopefully, the diarrhea clears up within a week of finishing the antibiotic course, but a review paper published in Expert Review of Anti-Infection Therapy says subtle changes to the microbiome may last much longer, the ultimate impact of which is unknown.

5 DO YOU FEEL ANXIOUS?

There is strong evidence that the gut and brain communicate. A recent paper published in the Annals of Gastroenterology concludes that gut microbes regulate brain chemistry in a way that affects how we respond to stress and anxiety. “The gut is the second brain of the body,” says King, “and research is starting to show that people suffering from anxiety and depression have altered gut flora.” The Gastroenterology paper reports that certain probiotics may reduce stress-related cortisol levels and anxious behavior, though King notes that “research is still ongoing to find out what good bacteria would be beneficial for our brains.”

6 DO YOU HAVE FOOD SENSITIVITIES?

Food sensitivities are diverse and have their own world of mysteries. King agrees, saying, “This is always a doozy and may be difficult to pin down without keeping food and symptom records.” She recommends working with a registered dietitian nutritionist (RDN) to help determine which foods might be causing problems. What experts in the field do know is that promoting good bacteria in the gut can help with some food sensitivities, such as lactose intolerance. A paper in the British Journal of Nutrition notes that the use of probiotics has helped those who have trouble absorbing lactose.

7 ARE YOU HAVING GASTROINTESTINAL DISTRESS?

Common gastrointestinal (GI) complaints that are easy to spot as gut health issues are bloating, gas, diarrhea, constipation, abdominal pain and cramping. They are so common that it’s not always easy to identify the cause. Symptoms could be due to any of a number of things; for example, food poisoning, drug side effects or an unhealthy balance of microbiota. These symptoms could be due to irritable bowel syndrome, a condition that could be caused by an imbalance of certain microbiota, which in turn could be caused by infections or antibiotics. These symptoms could also be part of inflammatory bowel disease in which the imbalance of microbiota may be causing inflammation and an immune response.

HOW TO ACHIEVE A HEALTHY GUT

Eating for a healthy microbiome conveniently looks a lot like eating in line with recommendations from health authorities like the American Heart Association, Dietary Guidelines for Americans and the World Health Organization. For instance, eat more produce and less meat and added sugar. Dr. Schreiber says the bottom line is to eat better. If that isn’t enough and symptoms persist, know when to ask for help. A registered dietitian nutritionist (RDN) can help design a specialized therapeutic diet for you, while a gastroenterologist can help diagnose and treat GI conditions.

HOW TO BE A PROBIOTIC PRO

The goal is to have plenty of good bacteria (probiotics) and to properly feed them with the right fuel (prebiotics). King recommends prebiotic foods like asparagus, apples, garlic and onions. To amp up your probiotic communities (good bacteria), King recommends including probiotic foods in the diet, such as yogurt, sauerkraut and miso. King says, “Taking a probiotic may be helpful as well.” Try cycling through various types of probiotics from recommended brands in order to get exposure to a wide variety of microflora species.